Different hemodynamic responses by color Doppler ultrasonography studies between sildenafil non-responders and responders

Abstract

Sildenafil non-responders were characterized by a poorer penile rigidity response to intracavernous injection and had an associated impaired veno-occlusive mechanism. Advanced age and comorbidity with diabetes mellitus were two common factors associated with non-response.

Combined intracavernous vasoactive drugs and sildenafil citrate in treatment of severe erectile dysfunction not responding to on-demand monotherapy

“…These results were comparable with the previously cited studies [17,18], where rigidity response grade 3 or 4 was found in a third of those with arterial insufficiency, 35% of those with VOD and 44% of those with normal response, while none of those with mixed vascular abnormality had positive response (grade 3 or 4) in the study of Huang and Hsieh [17]. The quality of erectile response to intracavernous pharmacological stimulation was found by Martins and Padma-Nathan [18] in 15 men with VOD to be poor or none in four (25%), adequate in three (20%) and excellent in eight (53%); in 19 men with mixed vascular types, poor or none in 12 (63%), adequate in three (16%) and excellent in four (21%); while 16 patients with arterial disease had an adequate response in 11 (69%) and excellent in five (31%).…”

“…In the present study we investigated the haemodynamic findings in 40 men not responding to sildenafil and ICI of PGE1, and tried to manage them with combined chronic low daily dose of sildenafil and ICI of triple-agent therapy, not on-demand use and with no dose increments. The underlying haemodynamic findings in non-responders to sildenafil [17] and ICI of vasoactive drugs has been investigated previously [18,19]. The common underlying vascular abnormalities were corporal VOD alone or combined with arterial insufficiency.…”

“…Martins and Padma-Nathan [18] found that 49% (34/69) of non-responders to ICI had VOD alone or combined with arterial disease, and this is the specific haemodynamic abnormality causing no response to ICI, while pure arterial insufficiency was found in 16/69 (23%). The vascular abnormalities found in sildenafil non-responders were investigated in the study of Huang and Hsieh [17], where they found VOD in 16/38 (45%), mixed VOD and arteriogenic in three (8%), pure arterial in nine (24%) and normal vascular parameters in nine (24%). They concluded that veno-occlusive ED was the commonest type in sildenafil non-responders and associated with poor penile rigidity.…”

Arterial erectile dysfunction: Different severities of endothelial apoptosis between diabetic patients “responders” and “non responders” to sildenafil

“…Moreover the EMPs may play a role as biomarkers of vascular injury; in fact, the study of Esposito and colleagues [24] showed the serum concentrations of EMPs are higher in diabetic men with ED than in nondiabetic potent men. Finally in the study of Huang and Hsieh [20], sildenafil "non responders" were characterized by a poorer penile rigidity response to intracavernous injection and had an associated impaired veno-occlusive mechanism. (3) 58.3% (7) Legend: risk factors considered are smoking, hypertension and dyslipidemia.…”

“…ED patients who reached satisfactory penile rigidity and a significant improvement in the IIEF-5 [19] after sildenafil treatment were classified as "responders". A successful response to sildenafil was defined as the ability to achieve vaginal penetration in ≥75% of attempts [20] and an increase >5 points assessed through IIEF-5 score [21].…”